<%@ Control Language="VB" AutoEventWireup="false" CodeFile="CInfo_Cor.ascx.vb" Inherits="WebForms_CInfo_Cor" %>
<%@ Register Assembly="AjaxControlToolkit" Namespace="AjaxControlToolkit" TagPrefix="ajaxToolkit" %>

<div id="divMain" runat="server">
    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr><td style="font-size: 3px;height: 5px;"></td></tr>
    </table>
    
    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr>
        <td id="Policy_td" runat="server" align="left" style="font-weight: bold; font-size: 10pt; font-family: Arial;">
        </td>
        <td></td>
        </tr>
        <tr>
        <td id="Provider_td" runat="server" align="left" style="font-weight: bold; font-size: 10pt; font-family: Arial;">
        </td>
        <td align="right" style="font-weight: bold; font-size: 10pt; font-family: Arial; color: #d63007;">
            Add New Individual
        </td>
        </tr>
    </table>

    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr><td style="font-size: 3px; background-color: #105BA4; height: 3px;"></td></tr>
    </table>
    
    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr>
        <td id="Name_td" runat="server" align="left" style="font-weight: bold; font-size: 10pt; font-family: Arial;">
        </td>
        </tr>
    </table>
    <asp:Label ID="lblSeqCd" runat="server" Text="" Visible="false"></asp:Label>
    <asp:Label ID="lblID" runat="server" Text="" Visible="false"></asp:Label><br />

    <table border="0" cellpadding="0" cellspacing="0" width="800">
    
    <tr>
    <!-- Start Menu -->
    <td style="width: 200px" valign="top">
    
        <table border="0" cellpadding="0" cellspacing="0" width="100%">
        <tr>
            <td style="height: 30px"><img src="../images/grayT.PNG" alt="selected" />
            </td>
            <td style="font-weight: bold; font-size: 10pt; font-family: Arial; width: 180px; height: 30px;" align="right">
            <asp:LinkButton ID="Main_Info_btn" runat="server" Font-Underline="False" 
                    ForeColor="#999999" CausesValidation="False">Main Information&nbsp;&nbsp;</asp:LinkButton>
            </td>
        </tr>
        <tr>
            <td style="height: 30px"><img src="../images/grayT.PNG" alt="selected" />
            </td>
            <td style="font-weight: bold; font-size: 10pt; font-family: Arial; width: 180px; height: 30px;" align="right">
            <asp:LinkButton ID="Other_Info_btn" runat="server" Font-Underline="False" 
                    ForeColor="#999999" CausesValidation="False">Other Information&nbsp;&nbsp;</asp:LinkButton>
            </td>
        </tr>
        <tr>
            <td style="height: 30px"><img src="../images/redT.PNG" alt="selected" />
            </td>
            <td style="font-weight: bold; font-size: 10pt; font-family: Arial; width: 180px; height: 30px;" align="right">
            <asp:LinkButton ID="Correspondence_btn" runat="server" Font-Underline="False" 
                    ForeColor="Black" CausesValidation="False">Correspondence&nbsp;&nbsp;</asp:LinkButton>
            </td>
        </tr>
        <tr>
            <td style="height: 30px"><img src="../images/grayT.PNG" alt="selected" />
            </td>
            <td style="font-weight: bold; font-size: 10pt; font-family: Arial; width: 180px; height: 30px;" align="right">
            <asp:LinkButton ID="Attachments_btn" runat="server" Font-Underline="False" 
                    ForeColor="#999999" CausesValidation="False">Attachments&nbsp;&nbsp;</asp:LinkButton>
            </td>
        </tr>
        <tr>
            <td style="height: 30px"><img src="../images/grayT.PNG" alt="selected" />
            </td>
            <td style="font-weight: bold; font-size: 10pt; font-family: Arial; width: 180px; height: 30px;" align="right">
            <asp:LinkButton ID="Risk_Profile_btn" runat="server" Font-Underline="False" 
                    ForeColor="#999999" CausesValidation="False">Risk Profile&nbsp;&nbsp;</asp:LinkButton>
            </td>
        </tr>        
        </table>
    
    </td>
    <!-- End Menu -->
    
    <!-- Start Content -->
    <td style="width: 600px">
    
    <table border="0" cellpadding="0" cellspacing="0" width="100%" style="background-color: #f2f3f5">
        <tr><td>        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 110px; height: 10px;" align="left">
                    <asp:LinkButton ID="Same_lbtn" runat="server" CausesValidation="False" Width="168px">Same as Main Address</asp:LinkButton></td>
            </tr>
            </table>
        </td></tr>        
    
        <tr><td style="width: 600px">
        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 110px; height: 28px;" align="left">
                    &nbsp;Address:</td>
                <td style="width: 190px; height: 28px" align="left">
                    <asp:TextBox ID="Add1_txt" runat="server" Width="188px"></asp:TextBox>
                </td>
                <td style="width: 299px; height: 28px" align="left">
                    <asp:TextBox ID="Add2_txt" runat="server" Width="288px"></asp:TextBox>
                </td>
            </tr>
            </table>
            
        </td></tr>
        <tr><td style="width: 600px">
        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 106px; height: 28px;" align="left">
                    &nbsp;City:</td>
                <td style="width: 190px; height: 28px" align="left">
                    <asp:DropDownList ID="City_cmb" runat="server" Width="194px">
                    </asp:DropDownList>
                </td>
                <td style="font-size: 10pt; font-family: Verdana; width: 105px; height: 28px;" align="left">
                    &nbsp;Country:</td>
                <td style="width: 195px; height: 28px" align="left">
                    <asp:DropDownList ID="Country_cmb" runat="server" Width="190px" AutoPostBack="True">
                    </asp:DropDownList>
                </td>
            </tr>
            </table>
            
        </td></tr>
        <tr><td style="width: 600px">
        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 106px; height: 28px;" align="left">
                    &nbsp;Zip Code:</td>
                <td style="height: 28px" align="left">
                    <asp:TextBox ID="Zip_txt" runat="server" Width="188px"></asp:TextBox>
                </td>
                <td style="font-size: 10pt; font-family: Verdana; width: 105px; height: 28px;" align="left">
                    &nbsp;Status:</td>
                <td style="width: 195px; height: 28px" align="left">
                    <asp:DropDownList ID="Status_cmb" runat="server" Width="190px">
                    </asp:DropDownList>
                </td>
            </tr>
            </table>
            
        </td></tr>
        </table>
                    
        <table border="0" cellpadding="0" cellspacing="0" width="100%" style="background-color: #f2f3f5">
        <tr><td>        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 110px; height: 10px;" align="left"></td>
            </tr>
            </table>
        </td></tr>        
        <tr><td>
        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 107px; height: 24px;" align="left">
                    </td>
                <td style="width: 190px; height: 24px;"></td>
                <td style="width: 150px; height: 24px;" align="center"><asp:Button ID="Save_btn" runat="server" Text="Save" 
                    BackColor="Gainsboro" Font-Names="Verdana" Width="80px" /></td>
                <td style="width: 150px; height: 24px;" align="center"><asp:Button ID="Cancel_btn" runat="server" Text="Back" 
                    BackColor="Gainsboro" Font-Names="Verdana" Width="80px" CausesValidation="False" /></td>
            </tr>
            </table>
            
        </td></tr>
        <tr><td>        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 110px; height: 10px;" align="left"></td>
            </tr>
            </table>
        </td></tr>        
        </table>             
        <ajaxToolkit:TextBoxWatermarkExtender ID="TextBoxWatermarkExtender1" runat="server"
            TargetControlID="Add1_txt" WatermarkText="No., Street, Floor, Bldg." WatermarkCssClass="WaterMk" >
        </ajaxToolkit:TextBoxWatermarkExtender>
        <ajaxToolkit:TextBoxWatermarkExtender ID="TextBoxWatermarkExtender2" runat="server"
            TargetControlID="Add2_txt" WatermarkText="Brgy., Village, Area, District" WatermarkCssClass="WaterMk">
        </ajaxToolkit:TextBoxWatermarkExtender>
        <asp:RequiredFieldValidator ID="rfv1" runat="server" ControlToValidate="City_cmb"
            ErrorMessage="City Required" ForeColor="White" Text="."></asp:RequiredFieldValidator><asp:RequiredFieldValidator
                ID="rfv2" runat="server" ControlToValidate="Country_cmb" ErrorMessage="Country Required"
                ForeColor="White" Text="."></asp:RequiredFieldValidator><asp:RequiredFieldValidator
                    ID="rfv3" runat="server" ControlToValidate="Status_cmb" ErrorMessage="Status Required"
                    ForeColor="White" Text="."></asp:RequiredFieldValidator>
        <asp:ValidationSummary ID="ValidationSummary1" runat="server" ShowMessageBox="True"
            ShowSummary="False" />
        <ajaxToolkit:ValidatorCalloutExtender ID="ValidatorCalloutExtender1" runat="server"
            TargetControlID="rfv1">
        </ajaxToolkit:ValidatorCalloutExtender>
        <ajaxToolkit:ValidatorCalloutExtender ID="ValidatorCalloutExtender2" runat="server"
            TargetControlID="rfv2">
        </ajaxToolkit:ValidatorCalloutExtender>
        <ajaxToolkit:ValidatorCalloutExtender ID="ValidatorCalloutExtender3" runat="server"
            TargetControlID="rfv3">
        </ajaxToolkit:ValidatorCalloutExtender>
    </td>
    <!-- End Content --></tr>
    
    </table>        
</div>
